AMD and GA: Genetics, Lifestyle, or Chance?
The risk factors for macular degeneration are a frequent topic of interest among our MacularDegeneration.net community members and Facebook community. I have heard more than 1 person lamenting an age-related macular degeneration (AMD) diagnosis in spite of a healthy lifestyle and no family history. Others are blessed with little progression over many years, while others experience rapid progression. Many of these people wonder why they have rapid progression while a family member or friend has little loss of vision after many years.
A tale of 2 sisters
My sister and I both have macular degeneration. The similarity stops there. The course of the disease has been vastly different for each of us; besides a shared family history of macular degeneration, we have different risk factors and have experienced very different outcomes.
My sister has had wet macular degeneration for approximately 15 years. She has been on all the injectable medications. Currently, she is receiving Vabysmo. After the loading doses, she has not needed any additional injections. Recently, she had to take the eye exam for her driver's license. She passed the test without glasses. She only needs glasses for reading.
I can't help but wonder why...
I was diagnosed with dry AMD 10 years ago. My vision has steadily declined. Last year, I was diagnosed with geographic atrophy (GA), the advanced form of dry AMD. My vision was 20/150 in my worst eye.
I can’t help wondering why my sister's vision is still good after 15 years while mine is approaching legal blindness in 1 eye. I carefully considered the lifestyle factors for each of us.
Diet and exercise
My sister is an insulin-dependent diabetic. She has a "sweet tooth" and enjoys Dr. Pepper and her favorite candy bars. She has never cared for fruit or green veggies.
I carry a few extra pounds I wish were gone. I have made an effort to eat a healthy diet with an emphasis on fruits and veggies.
My sister has several health issues that make it difficult for her to exercise. She takes short walks as her health allows. Until my recent fall, I tried to get at least 30 minutes of activity every day. I am concerned my overall health will decline, since my injuries are preventing me from my favorite activities: walking and gardening.
Smoking
We were born into a family of smokers. It wasn’t too surprising that we began smoking as adults. I smoked a total of 14 years before quitting in 1986.
My sister started smoking 60 years ago and stopped after a coronary bypass. She vapes, which her doctor thinks is less harmful than cigarettes.
Sun protection (or lack thereof)
We grew up in Oklahoma where summers are sunny and hot. Unfortunately, neither of us bothered with wearing sunglasses or hats to protect our eyes. After my diagnosis of AMD, I learned the importance of wearing eye protection. My sister wears sunglasses occasionally, but not consistently.
I believe chance played some role
My sister's approach to life is more in line with que sera, sera (what will be will be). I am thankful that she has retained good vision and sincerely hope it stays that way.
Though I have done all the things I know to slow progression, I developed GA. I am hopeful Izervay injections slow my progression, but it isn’t guaranteed. I plan to continue my healthy habits.
After reflecting on our very different lifestyles, I believe, in our case, chance played some role in the development and progression of AMD for me.
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